Introduction: Perforation of gas containing hollow viscus organs usually gives rise to a life threatening emergency which is most commonly managed by general surgeons. Methodology: This was a descriptive clinical study carried out at a Tertiary care hospital. Preoperative resuscitation of patients was done by fluids and electrolyte imbalance was corrected. Antibiotics like 3rd generation cephalosporins and metronidazole were used initially, later shifted according to culture and sensitivity. Results: In this study two patients expired, one patient of ileal (typhoid) perforation developed septicemia and expired on the day of surgery. Another patient of colonic carcinoma perforation had developed septic shock expired on post- perative day 3. Conclusion: Factors contributing to the high mortality and post-operative complications are advanced age, late presentation, delay in the treatment, septicaemia, and associated co-morbidity.